DR. MARK GUSTAVSON D.D.S.
NPI 1558685297
Dentist - General Practice in Madison, WI

Q: What is Mark Gustavson's NPI number?

The NPI number for Mark Gustavson is 1558685297. It was assigned to this individual provider in the NPPES registry on March 24, 2010.

Q: What is Mark Gustavson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Mark Gustavson was last updated on March 24, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 24, 2010PECOS Enrolled

5601 ODANA RD, MADISON, WI 53719(608) 274-9077 Get Directions Write a Review

NPPES record last updated: March 24, 2010. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Dr. Mark Gustavson D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK GUSTAVSON D.D.S. (NPI 1558685297) is an individual general practice provider in Madison, Wisconsin, licensed in Wisconsin (5968-015) and active in the NPI registry since March 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558685297

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. MARK GUSTAVSONCredential: D.D.S.

Location Address5601 ODANA RDMadison, WI 53719-1207

Mailing Address5601 Odana RdMadison, WI 53719-1207 · (608) 274-9077

Phone(608) 274-9077

Sole ProprietorNo

Enumeration DateMarch 24, 2010

✔ NPI 1558685297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in WI · 5968-015

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

5601 ODANA RD, Madison, WI 53719

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mark Gustavson D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53719 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRIAN DAVID PORTER DDS

Dentist (General Practice)